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General NPI Number Information
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NPI Number | 1154732477
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Entity Type | Organization
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Legal Business Name | USP ATWATER
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Dates
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Enumeration Date | 05/09/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1 FEDERAL WAY
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City | ATWATER
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State | CA
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Zip | 95301-5174
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Country | US
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Telephone | 209-386-4791
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FEDERAL WAY
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City | ATWATER
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State | CA
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Zip | 95301-5174
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Country | US
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Telephone | 209-386-4791
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Fax |
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Authorized Official
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Title or Position | HEALTH SERVICE ADMINISTRATOR
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Name | MRS. LOURDES METTRY
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Credential | R.N.
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Telephone | 209-386-4791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State | CA
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